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In February 2013, I considered myself the picture of health. Though forty-eight years of age, I felt that I was doing all of the right things. I was thin, ate a healthy Mediterranean diet, didn't smoke and exercised 4-5 times per week. In fact, I had even recently commented to my husband that I felt better than I had a decade earlier. Little did I know that I was soon to experience the biggest health crisis of my life.

For about a week, I felt a soreness in my left buttock radiating to my left thigh - no pain, just a feeling of slight bruising. I assumed that I had strained a muscle running or was developing a very mild sciatica. Again, there was no pain, just a general soreness. I continued to exercise, running 5 km every couple days and spinning in between. Suddenly, I noticed a very slight swelling in my left leg. My thigh felt flushed with blood and enormous, though the swelling was barely perceptible to others. My husband insisted I visit the ER and I reluctantly agreed. I felt it ridiculous to tie up medical personnel for a slightly swollen leg. Upon my arrival at the ER, an ultrasound of my leg was performed and I was diagnosed with a massive, potentially life threatening DVT. Within the hour, I was transported to another local hospital where catheter directed thrombolysis was later performed. I am now on a lifelong regimen of Coumadin and aspirin.

It is important to note that I do have two genetic clotting disorders. Factor V Leiden (homozygous) and Prothrombin gene mutation. These disorders put me at a higher risk for developing a blood clot than the average person. However, until this episode I had never experienced a blood clot in my life. I had three healthy pregnancies and deliveries, traveled by air extensively, etc., all without incident.

Pay attention to any changes in your lower extremities, even if you feel no pain.

If you have DVT in your family, consider getting tested for genetic clotting disorders.

If you do have a clotting disorder, talk to your hematologist about preventative measures.

Editor's Note

There are two additional considerations that the reader should be aware of regarding this patient's story:

The use of aspirin (and other drugs that act in a similar manner to reduce the risk of clots) in combination with warfarin is something that should be carefully considered by a patient's own physician. While there are some reasons to use both agents together, the combined use increases the risk of bleeding which may occur in the stomach and intestines or a number of other locations in the body. One recent study in thousands of patients found that taking aspirin with warfarin was associated with an 80% increase in the risk of bleeding into the head (which may lead to a stroke that can be life-threatening). Ref: Hart RG, et al. Stroke 2012; 43:1511-1517.

Despina has two hypercoagulable conditions. A hypercoagulable condition is a condition that increases the risk of blood clotting. Factor V Leiden (where "V" is the Roman numeral for 5) and Prothrombin Gene mutation are hypercoagulable conditions. The Factor V Leiden is also referred to as "activated protein C resistance" and Prothrombin Gene mutation is referred to as "mutant Factor II". For unclear reasons, patients with one hypercoagulable condition have a higher than average risk of having a second hypercoagulable condition. Also, because these 2 (but not all) hypercoagulable conditions are inherited; individuals who have blood relatives with blood clots and/or one of these conditions should realize that they may be at risk of having one of these conditions. Whether children of parents with hypercoagulable conditions should be evaluated is a controversial issue that should be discussed with a blood specialist (hematologist) and, perhaps, someone who can advise the patient on the potential risk of "labeling" any of the children with such a diagnosis (which may affect their ability to secure health and/or life insurance).